Chemotherapy-Induced Alopecia

Chemotherapy-induced alopecia (CIA) is a frequent toxicity and arguably the most feared side effect of cancer chemotherapy (Carelle et al., 2002). The incidence of CIA is approximately 65% of all patients (Wang et al., 2006). CIA could be easily noticeable by self and others in a relative short time, thus it is linked with having cancer and chemotherapy. CIA compromises patient quality of life, especially for female and children, leading to poor therapeutic outcome. Despite significant progresses and substantial efforts in CIA research and development, no reliable and effective preventive treatment has become available. This limitation has been attributed to the lack of basic understanding of CIA pathogenesis and appropriate experimental models. This chapter will provide an overview of the basic and clinical aspects of CIA including hair follicle biology, characteristics of CIA along with the state-of-the-art experimental models and treatment strategies. Experimental approaches for pharmacologic inhibition of CIA including drug-specific antibodies, hair growth cycle modifiers, cytokines, growth factors, antioxidants, cell cycle modifiers, and apoptosis inhibitors will be discussed. Current understanding in the molecular mechanisms of CIA and the role of specific genes, e.g. p53 and Fas, in the process will also be discussed. The chapter will conclude with the perspective on the prevention and management of CIA.